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Caesarean obesity risk

Caesarean delivery could increase obesity in offspring

Nearly 1.3 million caesareans are performed each year in the US, accounting for one third of all deliveries
the researchers also found that individuals born via vaginal birth among women who had undergone a previous caesarean delivery were 31% less likely to become obese compared with those born via caesarean birth following a caesarean birth

Individuals born by caesarean delivery were 15% more likely to become obese as children than individuals born by vaginal birth and the increased risk may persist through adulthood, according to a study from Harvard TH Chan School of Public Health. In addition, individuals born via caesarean delivery were 64% more likely to be obese than their siblings born by vaginal birth.

In the study, ‘Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood’, will be published online in JAMA Pediatrics, the researchers also found that individuals born via vaginal birth among women who had undergone a previous caesarean delivery were 31% less likely to become obese compared with those born via caesarean birth following a caesarean birth.

"Caesarean deliveries are without a doubt a necessary and lifesaving procedure in many cases," said Jorge Chavarro, associate professor of nutrition and epidemiology at Harvard Chan School and senior author of the study. "But caesareans also have some known risks to the mother and the newborn. Our findings show that risk of obesity in the offspring could another factor to consider."

Nearly 1.3 million caesareans are performed each year in the US, accounting for one third of all deliveries. While a number of previous studies have suggested a link between caesarean delivery and a higher risk of obesity in offspring, the studies were either too small to detect a clear association or lacked detailed data.

The new analysis included 16 years' worth of data from more than 22,000 young adults in the Growing Up Today Study (GUTS), in which participants answered survey questions every year or two years from 1996-2012. The researchers looked at the participants' body mass index (BMI) over time; at whether or not they were delivered via caesarean (using information collected from participants' mothers, participants in the Nurses' Health Study II); and at other factors that could play a role in obesity, such as the mothers' pre-pregnancy BMI, smoking status, age at delivery, and where they lived. They also looked at whether the mothers had previous caesarean deliveries.

"I think that our findings - particularly those that show a dramatic difference in obesity risk between those born via caesarean and their siblings born through vaginal delivery - provide very compelling evidence that the association between cesarean birth and childhood obesity is real," said Chavarro. "That's because, in the case of siblings, many of the factors that could potentially be playing a role in obesity risk, including genetics, would be largely the same for each sibling - except for the type of delivery."

“Since large randomized trials of caesarean vs vaginal birth may not be ethically feasible, additional research from large, prospective studies with high-quality data on prepregnancy, pregnancy, and delivery is needed to address whether these findings are generalisable to minorities and to investigate whether increased rates of obesity translate to increased risk of adverse cardiometabolic outcomes among individuals born by caesarean delivery,” the authors conclude.

To access the paper, please click here

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